徐州市新生儿疾病筛查8年分析与总结

目的:了解徐州市新生儿疾病筛查的情况。方法:选取2003年1月～2010年3月徐州市697873例接受先天性甲状腺功能减退症(CH)和苯丙酮尿症(PKU)筛查的新生儿,于出生72 h后采足跟血制成滤纸干血片,应用时间分辨免疫荧光法检测血片中促甲状腺激素(TSH)和苯丙氨酸(Phe)含量,TSH值≥9 mIU/L或Phe值≥2.0 mg/dl的新生儿视为可疑阳性,召回复查并进一步确诊。结果:所选新生儿中共确诊CH患儿334例,发病率为0.48‰,PKU患儿70例,发病率为0.10‰。徐州市CH发病率高于全国平均水平,PKU发病率和全国平均水平相近。结论:加大宣传力度、加强新筛管理、提高血片质量是保证新生儿疾病筛查成功的关键。新生儿疾病筛查是利国利民的卫生事业,需要国家及群众的大力支持。     

扬州市2004～2009年新生儿疾病筛查回顾性分析

目的:回顾扬州市新生儿先天性甲状腺功能减低症(CH)和苯丙酮尿症(PKU)6年来筛查情况,总结经验、查找不足,以促进新生儿疾病筛查工作。方法:新生儿出生后72 h采足跟末梢血制成滤纸干血片,用时间分辨免疫荧光分析法(DELFIA)检测血片中促甲状腺素(NTSH)和苯丙氨酸(Phe)含量,筛查切值NTSH≥9.0 mIU/L,Phe≥2.0 mg/dl,对初筛结果超过相应切值者,取原血片复检,复检仍阳性者,立即通知重新采血复测。结果:共筛查新生儿137 285例,确诊患儿CH43例,CH发病率为1∶3 193,男、女之比为1.08∶1,确诊PKU患儿14例,PKU发病率为1∶9 806,男、女之比1.33∶1。结论:扬州市CH和PKU发病率处于全国平均水平,各级政府部门和妇幼保健机构应加强新生儿疾病筛查网络建设、管理,进一步提高筛查覆盖率。     

新生儿疾病筛查与干预效果分析

[目的] 总结陕西省新生儿疾病筛查中心开展工作以来,甲状腺功能低下(congenital hypotlwoidism,CH)和苯丙酮尿症(phenylketonuria,PKU)筛查结果和干预效果. [方法] 陕西省筛查网络出生的新生儿,CH筛查采用时间分辨荧光免疫法检测滤纸干血片中促甲状腺素含量;PKU筛查采用荧光法检测滤纸干血片中苯丙氨酸(phenylalanine,Phe)含量. [结果] CH发病率1/2 990;PKU发病率1/7 849,未检出四氢生物嘌呤缺乏症.经过规范治疗的19例CH和7例PKU患儿智能与正常同龄儿比较,达到正常水平. [结论] 新生儿疾病筛查可以使CH、PKU及早确诊,早期干预,避免发生智能障碍.     

沈阳地区126067例新生儿疾病筛查状况分析

目的:为探讨沈阳地区新生儿先天性甲状腺功能低下(CH)和苯丙酮尿症(PKU)的发病率及治疗。方法:对新生儿出生后72 h充分哺乳6~8次后采足跟血,采用免疫荧光法测定血TSH浓度,荧光法测定Phe含量。对确诊的CH患儿采用甲状腺素替代疗法,PKU患儿采用低Phe食品治疗并定期复查。结果:5年共筛查新生儿126 067例,CH发病率为1/3 232,PKU为1/8 404。沈阳地区发病率明显高于全国平均数(CH为1/4 000、PKU为1/10 000)。结论:新生儿疾病筛查是目前CH、PKU早期诊断的最佳途径,可以使患儿得到早期治疗,是降低残疾儿的发生和提高沈阳地区人口素质的重要措施。     

新生儿先天性甲状腺功能减低症筛查10年回顾

目的了解武汉市CH发病率及10年筛查情况,总结经验、查找不足以指导今后筛查工作。方法CH筛查方法为新生儿出生后72h、采足跟末梢血制成干血滤纸片,用EIA法或ELISA法检测血片中TSH含量,将EIA法TSH值≥10mIU/L或ELISA法≥20mIU/L的新生儿判为筛查阳性,并召回确诊。结果武汉市10年来,共筛查新生儿271221例,确诊CH患儿125例,CH发病率为0.461‰,男、女之比为1∶1.23,10年CH发病率无显著上升或下降趋势;用ELISA法和用EIA法检测的CH发病率之间无显著差异。结论武汉市是CH高发地区,各级政府部门和妇幼保健机构应加强新生儿疾病筛查网络建设及管理,进一步提高筛查覆盖率;业务技术指导部门应加强标本采集和实验人员的培训;选择适当的筛查、实验方法,完善质控机制;降低CH患儿发生率,提高武汉市出生人口素质。     

武汉市新生儿苯丙酮尿症筛查11年分析研究

目的:回顾武汉市新生儿苯丙酮尿症11年筛查情况,总结经验、查找不足,促进筛查工作。方法:新生儿出生后72h,采足跟末梢血制成滤纸干血片,检测血片中Phe含量,将Phe值≥240μmol/L(BIA法)或≥120μmol/L(荧光法)的新生儿判为初筛阳性,召回复查确诊。结果:11年来,武汉市筛查新生儿321881例,确诊PKU患儿15例,PKU发病率为0.47/万;PKU发病率无显著上升或下降趋势;用BIA法筛出的PKU发病率与用荧光法筛出的发病率无显著差异。结论:武汉市PKU发病率处于相对稳定的较低水平,用荧光法筛查要优于BIA法,新筛实验室应尽可能使用荧光法,既可降低初筛阳性率,又能提高检出率。要提高筛查覆盖率,加强PKU与BH4的鉴别诊断,研究武汉市PKU患儿家族苯丙氨酸羟化酶基因突变情况,为PKU的产前诊断提供依据。     

建湖县2002～2011年新生儿疾病筛查结果分析

目的:分析建湖县2002～2011年新生儿疾病筛查和发病情况,为今后实施一级预防提供依据。方法:建湖县20个接产单位住院分娩的活产新生儿在出生72 h并充分哺乳后采集足跟血制成滤纸干血片,分别应用时间分辨荧光法和荧光法分析检测血片中促甲状腺素(TSH)和苯丙氨酸(Phe)含量。TSH值>8 mIU/L或Phe值>1.8 mg/dl的新生儿视为可疑阳性,召回复查并进一步确诊。结果:10年筛查活产新生儿55 417例,平均筛查率83.40%;可疑阳性患儿586例,召回率99.49%;确诊先天性甲状腺功能减低症(CH)患儿41例,发病率为0.74‰;苯丙酮尿症(PKU)患儿7例,发病率为0.13‰。建湖县CH、PKU发病率均高于发达国家和全国平均水平。结论:领导高度重视、开展宣传培训、加强质量管理、重视规范治疗是新生儿疾病筛查成功的关键。     

大连市19214例新生儿疾病筛查分析

为探讨大连市新生儿先天性甲状腺功能低下 ( CH)和苯丙酮尿症 ( PKU )的发病率及治疗方法 ,对新生儿出生后 72 h充分哺乳后采足跟血 ,采用双抗体夹心法测定血 TSH浓度 ,免疫荧光法测定 Phe含量。对确诊的 CH患儿采用甲状腺素替代治疗 ,PKU患儿采用低 Phe奶粉治疗并定期随访。结果新生儿筛查率达 98.46% ,CH发病率为1/ 2 40 1,PKU为 1/ 960 7。说明新生儿疾病筛查可使患儿得到早期诊治 ,是提高我国人口质量的重要措施     

2010-2016年陕西省新生儿疾病筛查治疗及随访结果分析

目的 总结并分析2010-2016年陕西省新生儿疾病筛查中心高苯丙氨酸血症(HPA)、先天性甲状腺功能减低症(CH)的筛查及治疗、随访情况。方法 新生儿出生72 h后采集足跟血,制成干血滤纸片,采用荧光法检测滤纸干血斑中苯丙氨酸(Phe)、促甲状腺素(TSH)的水平,Phe ≥2.0 mg/dl、TSH ≥10 μU/ml为阳性,阳性病人召回复查,采用串联质谱法检测血Phe、酪氨酸(Tyr),化学发光免疫分析技术检测甲状腺功能五项(TSH、T₃、T₄、FT₃、FT₄)而确诊。结果 2010-2016年全省助产机构活产数共2 751 268例,接受筛查2 329 335例,筛查率84.67%;确诊轻度HPA 131例,发病率1/17 781;确诊苯丙酮尿症(PKU) 300例,发病率1/7 764; 确诊CH 966例,发病率1/2 411。确诊后即建立病历档案,分别给予低苯丙氨酸饮食及口服左旋甲状腺素片(L-T₄)替代治疗。通过Gesell发育量表监测发育情况,发现6月龄内开始接受治疗的PKU患儿智商(IQ)水平明显优于6月龄后开始治疗的患儿(P<0.01),筛查确诊后即坚持治疗随访的CH 患儿,其IQ与正常同龄儿无明显差异(P>0.05)。结论 全面开展新生儿疾病筛查,提高筛查覆盖率,尽早规范化开始治疗及长期随访监测,可使PKU、CH患儿避免体格和智力不可逆损害,对改善其预后和生存质量意义重大。     

随州市12656例新生儿疾病筛查四项结果分析

目的对随州市各区县医疗机构出生的活产新生儿进行先天性甲状腺功能减低症(CH)、苯丙酮尿症(PKU)、葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症、先天性肾上腺皮质增生症(CAH)筛查,减少残疾儿的发生。方法以随州市2018年12 656例新生儿为研究对象,在出生72 h后充分哺乳6次以上,采足跟血制成滤纸干血片,检测血片中促甲状腺激素(TSH)、苯丙氨酸(Phe)、G6PD、17a-羟孕酮(17a-OHP)的含量。结果 CH确诊16例,发病率1/791;PKU确诊1例,发病率1/12 656;G6PD缺乏症确诊43例,发病率1/294;CAH确诊1例,发病率1/12 656。结论新生儿疾病筛查是早期诊断CH、PKU、G6PD缺乏症、CAH的有效措施,是降低患儿致残率、提高人口素质的关键。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.